Results of Long-Term Follow-Up Observations of Blepharoptosis Correction Using the Palmaris Longus Tendon

Abstract

Background The frontalis sling procedure is a useful approach for correcting severe blepharoptosis. However, blepharoptosis often recurs after corrective surgery using the tensor fascia lata. Good results without recurrence after a modified Fox method were obtained using the palmaris longus tendon. This study examined the safety and validity of the surgical method using the palmaris longus tendon through long-term follow-up observations. Methods To reduce the rate of recurrence, the highest point on the pentagon of the Fox method was fixed to the frontalis fascia and frontalis muscle. It was fixed once again to the area 1 cm above the highest point. This approach remarkably reduces the incidence of recurrence by fixing the pentagon of the Fox method not only to the palmaris longus tendon but also to the frontalis fascia and again to the frontalis muscle. A modified Fox method using the palmaris longus tendon was used to treat 16 eyelids of 10 patients. A senior surgeon performed the procedure in all cases under local anesthesia. Results The mean follow-up period was 51 months (range = 18-86 months). There was no case of blepharoptosis recurrence and a good field of view was secured after surgery. Long-term follow-up revealed that the visual field had been well secured with a mean MRD1 of 3

Incidence of agenesis of palmaris longus in the Andhra population of India

“…The long tendon of PL is the first choice of the surgeons frequently been grafted[ 25 ] because of its length, diameter and easy availability, which when harvested does not produce any functional deformity. [ 5 ] As evolutionary changes made PL a retrogressive degenerating muscle, its position and size can be altered or completely may be absent.…”

The palmaris longus muscle and its relations with the antebrachial fascia and the palmar aponeurosis

“…It has been used in the reconstruction of other tendons (Mountney et al, 1998;Lin et al, 2004;Unglaub et al, 2006;Chu et al, 2008), for frontalis suspension in the treatment of blepharoptosis (Kurihara et al, 1984;Lam et al, 1996;Park and Shin, 2008), as a substitute for ligaments in the stabilization of joints (Jackson and Saint Onge, 1977;Scheker and Ozer, 2004;Furukawa et al, 2007) or of the digital pulleys (Kaufmann and Pacek, 2006), and for the reconstruction of lip (Gürlek et al, 2005;Cinar et al, 2007) and eyelid defects (Ueda et al, 2007). The palmaris longus tendon is also used as a topographical landmark for surgery in the wrist area (Brones and Wilgis, 1978) and the muscle should be considered as a possible cause of ulnar or median nerve compression syndromes (Tiengo et al, 2006) or of forearm pseudo-masses when hypertrophied (Polesuk and Helms, 1998).…”

Study of Palmaris Longus Tendon among the Undergraduate Medical Students

“…25 Though the evolutionary changes made PL a retrogressive degenerating muscle it still becomes one of the favourite tendons for the surgeons to be used in graft because of its adequate length, width and easy availability. 34 Some researchers had also reported the similar studies in cadavers 30 and some had used magnetic resonance imaging (MRI) technique where they finally came with the conclusion that the mean width of tendons calculated by MRI were similar with those reported by cadaveric studies. 32 But in the present study, only the physical examination tests were included and the confirmation by MRI could not be done as by other authors as it was not cost -effective and more time consuming hence the study was not generalized.…”